Pitch to CEO

[sweetalkr]

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I fell into a great conversation with the right person, and he is setting me up with the CEO of a hospital that needs a Pain Department made from scratch. They want me to head it and i will be pitching it next week. I have never done this.

I think I know the basics of a sustainable model, however does anyone have any tips as to what a CEO of a hospital wants to hear or what I should say? ANY help is appreciated. i was going to start with the basic fundamental model, and the guy that intro'd me is the head of the neurosurgery institute with 43 MD/DO's in the practice and they would send their patients to me, so it sounds lucrative. i just don't know how to say anything other than "get me a fluoro, an MA, a nurse, and lets rock and roll"

 

[emd123]

You need to show him how much money in dollars he'll be making off facility fees from your injection, per year. This is the main selling point to a CEO. He won't really care about the medicine/multidisciplinary blah blah blah.

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[DO1987]

As mentioned above, he'll want to see the profitability. How much is this going to cost the hospital? How much equipment is needed? How many FTE's? How many patients can you guarantee, and at what growth rate (this helps determine the length of time of a break even point, and beyond.) Is their competition in the market? (who's to say this neurosurgeon wouldn't like doing business at this hospital and would decide to change his referrals?)

These are the things CO's look for

 

[specepic]

I am sorry to say the first thing I did when I read your post was cringe. I would not move forward with unbridled optimism but caution. Hosp admin can be very nice and welcoming at first, once hired can drive you nuts. Anything you think you want, have in writing. I work for a hosp and have a good set-up, but that took A LOT of work and street smarts on my part, and even then there are struggles.

 

[emd123]

I am sorry to say the first thing I did when I read your post was cringe. I would not move forward with unbridled optimism but caution. Hosp admin can be very nice and welcoming at first, once hired can drive you nuts. Anything you think you want, have in writing. I work for a hosp and have a good set-up, but that took A LOT of work and street smarts on my part, and even then there are struggles.

Agree. Business is business, and business can be cutthroat.

 

[nvrsumr]

Youll order MRIs, Labs(UDS etc..), EMGs, surgical consults, anesthesia for your cases at the ASC and or hospital, your professional fees and E&M, as well as referals to Spine, Ortho and neurology with some of those pts having a surgical stay at the hospital. Plus youre a "liason" to the PCPs in the community

Make sure you have an idea of how much you will bring year 1,2,3 etc... and how much youll cost them. Youll be amazed how much freaking $ they are gonna make off you....

 

[Tenesma]

be careful how hard you sell the income you will generate --- because
a) they may just hire somebody else
b) if you are too much of a pain in the neck, they may hire somebody else

 

[Ducttape]

give him generalities, such as using MGMA data to suggest the average amount of RVUs a pain physician in your area can generate. Obviously, you dont want to get tied down to specifics.

Obviously, you will want to stay PP, but the facilities fees are what you are going to use to entice him.

they may want to hear that you will do inpatient consults. they may want to hear that you will help monitor opioid use, but you obviously need to let him (subtly) know that the days of pain clinics writing all the opioids are over.

 

[nvrsumr]

give him generalities, such as using MGMA data to suggest the average amount of RVUs a pain physician in your area can generate. Obviously, you dont want to get tied down to specifics.

Obviously, you will want to stay PP, but the facilities fees are what you are going to use to entice him.

they may want to hear that you will do inpatient consults. they may want to hear that you will help monitor opioid use, but you obviously need to let him (subtly) know that the days of pain clinics writing all the opioids are over.

"Over" until the independent payment advisory board reviews pain procedures and cuts off medicare funding.

 

[emd123]

"Over" until the independent payment advisory board reviews pain procedures and cuts off medicare funding.

I went to a lecture on the impact of the ACA a few days ago. The speaker said there is good reason to believe the IPAB will not go into effect for two reasons. One, there is significant opposition in both parties since it super-cedes Congressional power and, two, the Medicare cuts of the past few years have unexpectedly caused Medicare expenditures to actually level off and actually go down slightly this year.

Food for thought.

 

[hyperalgesia]

I fell into a great conversation with the right person, and he is setting me up with the CEO of a hospital that needs a Pain Department made from scratch. They want me to head it and i will be pitching it next week. I have never done this.

I think I know the basics of a sustainable model, however does anyone have any tips as to what a CEO of a hospital wants to hear or what I should say? ANY help is appreciated. i was going to start with the basic fundamental model, and the guy that intro'd me is the head of the neurosurgery institute with 43 MD/DO's in the practice and they would send their patients to me, so it sounds lucrative. i just don't know how to say anything other than "get me a fluoro, an MA, a nurse, and lets rock and roll"

I've never done this before either... But I really think these guys are used to people overselling themselves and the money they can generate.

My only impression from talking with CEOs so far has been that they have a chip on their shoulder when it comes to doctors.

 

[geauxg8rs]

I heard conjecture on national news media (fwiw) state that there is good chance that ipab consist of empty chairs.

 

[sweetalkr]

Wow thank you for the responses. I truly appreciate the help. Yes I have heard many horror stories about the hire/fire hospitals, but it is also attached to an academic center, so I feel like being in an academic place may be more safe? Now I just feel naive by even writing it.
1) What is FTE?
2) Can i get MGMA data without having to pay/sign up? Or am I just being stingy? My mindset is still a resident's
3) How do I know how much I will bring in?
All i know so far is they want an academic program that generates private money.. I don't know how to know how much money I can bring in. Although I just emailed the CEO asking more specifics as to how many patients I would see, if i need to bring patients in from the community, etc..
also, specepic, can I PM you or if you don't mind telling me what you recommend as a "must" in my contract to make it as "fair" as possible for me as a physician?
I can't thank y'all enough.

 

[sweetalkr]

Also is there a sight to collect facility fees, etc? I have like a week before the meeting 🙂

 

[emd123]

Asipp.org

"Fee schedules"

 

[SSdoc33]

Wow thank you for the responses. I truly appreciate the help. Yes I have heard many horror stories about the hire/fire hospitals, but it is also attached to an academic center, so I feel like being in an academic place may be more safe? Now I just feel naive by even writing it.
1) What is FTE?
2) Can i get MGMA data without having to pay/sign up? Or am I just being stingy? My mindset is still a resident's
3) How do I know how much I will bring in?
All i know so far is they want an academic program that generates private money.. I don't know how to know how much money I can bring in. Although I just emailed the CEO asking more specifics as to how many patients I would see, if i need to bring patients in from the community, etc..
also, specepic, can I PM you or if you don't mind telling me what you recommend as a "must" in my contract to make it as "fair" as possible for me as a physician?
I can't thank y'all enough.

FTE: Full Time Equivalent

You wont know exactly how much you will bring in. A decent pain doc may collect 800K/year in fees. A good one 1 mil. A really good (or really busy, depends how you define it) can brink in 1.2 mil or more. The first year, you may be looking at more like 600K or so to start out.

The hospital collects the facility fees, which are in addition to that, and are the cash cow for the hospital.

The hospital may have different numbers as far as RVU data, etc. I could be wrong, but i believe that there is different MGMA data for academic institutions vs. private practice. At least thats how it was explained to me.

you realize that you are essentially entering a situation that is sort of like trying to play Phil Ivey in a round of poker. They are holding all the cards, and have years of practice doing this sort of stuff. they will not give you all the info you will want, and will not open their books for you. Unfortunately, it will most likely boil down to how much you trust the CEO/people you are dealing with. try to get a sense of the person. get a sense of HOW they are saying what they are saying, not just WHAT they are saying.

 

[Ducttape]

Wow thank you for the responses. I truly appreciate the help. Yes I have heard many horror stories about the hire/fire hospitals, but it is also attached to an academic center, so I feel like being in an academic place may be more safe? Now I just feel naive by even writing it.
1) What is FTE?
2) Can i get MGMA data without having to pay/sign up? Or am I just being stingy? My mindset is still a resident's
3) How do I know how much I will bring in?
All i know so far is they want an academic program that generates private money.. I don't know how to know how much money I can bring in. Although I just emailed the CEO asking more specifics as to how many patients I would see, if i need to bring patients in from the community, etc..
also, specepic, can I PM you or if you don't mind telling me what you recommend as a "must" in my contract to make it as "fair" as possible for me as a physician?
I can't thank y'all enough.

what is a "must" is that you need to have your contract reviewed by a contract attorney before signing it, so you know exactly what you are getting in to.

one FTE is the equivalent of a doc working 100% clinically. For academic medicine, there are several pathways set up. Simply, they are Clinician, Academic, and Administrative tracks, all with set criteria to advance to that holiest levels, Full Professorship. Full Professorship means you have "tenure", and it becomes very difficult to get fired. The tracks are usually bunched with certain activities - for example clinician-teacher, academic-administrative. Based on the track, certain amount of time is dedicated directly to clinical activities (i.e. real work), and the rest for academic/administrative pursuiots.

Usually people start at the Instructor level. To get to assistant professor is a matter of time and/or doing some academic research. its more stringent getting to Associate Professor. Usually there is a time frame, such as 7 years. By that time, an "applicant" has to show that he has performed - for academics, it is usually a certain number of research papers/articles, or a major grant like an R01.



how much you bring in is highly dependent on the patient population. i think the numbers quoted are quite good, but if you see >30% medicaid, for example, i highly doubt you will see 1.2 million in physician fees.

they probably want you to set up a clinic where you get a % of physician fees and they get all the facilities fees...

 

[sweetalkr]

Thank you so much, everyone. I don't know how the meeting will be. Next week I will update what my experience was, just for the young guys to know what happens and for the other guys to confirm or *hopefully* realize that maybe there are some nice people out there that want doctors to succeed. haha jk about that last line